Posted: May 3rd, 2023

Practice Issue and PICO(T) Question

Create a 3-5 page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.
Introduction
PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.
It stands for:
P – Patient/population/problem.
I – Intervention.
C – Comparison (of potential interventions, typically).
O – Outcome(s).
T – Time frame (if time frame is relevant).
The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. When applying the PICO(T) approach, the nurse can isolate the interventions of interest and compare to other existing interventions for the evidenced impact on the outcome of the concern.
You are encouraged to complete the Vila Health PICO(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.
Reference
Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Jones & Bartlett Learning.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.
PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related to the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question. When writing a PICO(T)-formatted research question, you want to focus on the impact of the intervention and the comparison on the outcome you desire.
Scenario
For this assessment, please use a health care issue of interest from your current or past nursing practice.
If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.
Instructions
For this assessment, select a health care issue of interest and apply the PICO(T) process to develop the research question and research it.
Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.
If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful.
In your submission, make sure you address the following grading criteria:
Define a practice issue to be explored via a PICO(T) approach. Create a PICO(T)-formatted research question
Identify sources of evidence that could be potentially effective in answering a PICO(T) question (databases, journals, websites, etc.).
Explain the findings from articles or other sources of evidence as it relates to the identified health care issue.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
Assessment 3 Example [PDF].
Additional Requirements
Your assessment should meet the following requirements:
Length of submission: Create a 3-5-page submission focused on defining a research question and interpreting evidence relevant to answering it.
Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to the current APA style.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
Explain the findings from articles or other sources of evidence that are relevant to the health care issue.
Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Competency 3: Apply an evidence-based practice model to address a practice issue.
Define a practice issue to be explored via a PICO(T) approach and develop a PICO(T)-formatted research question.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

____________________________________
Practice Issue and PICO(T) Question

The practice issue that will be explored is the use of physical restraints in the management of patients with delirium. Delirium is a state of confusion and rapid changes in brain function, which is common in critically ill patients. Physical restraints are frequently used as a preventive measure for patients with delirium, but they are associated with several adverse outcomes, including physical injuries, psychological distress, increased length of hospital stay, and increased risk of death. Therefore, it is important to determine whether physical restraints are effective in reducing adverse outcomes in patients with delirium.

The PICO(T) question that will be developed is as follows:

Population: Hospitalized patients with delirium
Intervention: Non-pharmacologic interventions
Comparison: Physical restraints
Outcome: Reduction of adverse outcomes, including physical injuries, psychological distress, length of hospital stay, and risk of death
Time Frame: Within the hospital stay

Sources of Evidence

The following databases were used to search for evidence: PubMed, CINAHL, and Cochrane Library. The search terms used were “delirium,” “physical restraints,” “non-pharmacologic interventions,” “adverse outcomes,” and “hospitalized patients.” The search was limited to English language articles published within the last 5 years.

Two relevant sources of evidence were identified and are summarized below.

Evidence Summary

Flannery, A. H., Oyler, D. R., & Weinhouse, G. L. (2021). Management of Delirium in Critically Ill Patients. American Journal of Critical Care, 30(3), 233–241.
This article provides an overview of the management of delirium in critically ill patients, with a focus on non-pharmacologic interventions. The authors suggest that non-pharmacologic interventions, such as early mobilization, cognitive stimulation, and sensory stimulation, may be effective in reducing the incidence and severity of delirium. The authors note that physical restraints are associated with adverse outcomes, including pressure ulcers, disorientation, and psychological distress, and should be avoided whenever possible. The article concludes that a multimodal approach that includes non-pharmacologic interventions is the most effective way to manage delirium in critically ill patients.

Krewulak, K. D., Stelfox, H. T., Ely, E. W., Fiest, K. M., & Mathew, R. (2020). Interventions for preventing and reducing the use of physical restraints in intensive care patients: a systematic review and meta-analysis. Critical Care, 24(1), 1–13.
This systematic review and meta-analysis evaluated the effectiveness of interventions for preventing and reducing the use of physical restraints in critically ill patients. The authors identified 10 randomized controlled trials that evaluated a variety of interventions, including education and training, environmental modifications, and the use of alternative devices, such as bed alarms and bed exit sensors. The authors found that interventions that targeted nursing staff were the most effective in reducing the use of physical restraints. The authors concluded that a multimodal approach that includes education and training for nursing staff is the most effective way to reduce the use of physical restraints in critically ill patients.

Relevance to Decision-Making

The evidence presented in these two sources suggests that non-pharmacologic interventions, such as early mobilization, cognitive stimulation, and sensory stimulation, may be effective in reducing the incidence and severity of delirium. Furthermore, physical restraints are associated with adverse outcomes and should be avoided whenever possible. The evidence also suggests that a multimodal approach that includes education and training for nursing staff is the most effective way to reduce the use of physical restraints

Check Price Discount

Study Notes & Homework Samples: Topic: Medication Errors »NURS90155: Nursing of Acute Health Conditions